{"id":23,"date":"2023-07-09T18:43:23","date_gmt":"2023-07-09T17:43:23","guid":{"rendered":"https:\/\/welltopia.care\/?page_id=23"},"modified":"2023-07-13T18:38:41","modified_gmt":"2023-07-13T12:38:41","slug":"add-patient","status":"publish","type":"page","link":"https:\/\/welltopia.care\/?page_id=23","title":{"rendered":"Add Patient"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"23\" class=\"elementor elementor-23\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-9d6c831 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"9d6c831\" data-element_type=\"section\" data-settings=\"{&quot;jet_parallax_layout_list&quot;:[]}\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ea19610\" data-id=\"ea19610\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ecb262b elementor-widget elementor-widget-jet-form-builder-form\" data-id=\"ecb262b\" data-element_type=\"widget\" data-widget_type=\"jet-form-builder-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style id=\"jet-form-builder-137-inline-css\"><\/style><form  class=\"jet-form-builder layout-column submit-type-reload\" action=\"https:\/\/welltopia.care\/?jet_form_builder_submit=submit&amp;method=reload\" method=\"POST\" data-form-id=\"137\" data-layout=\"column\" enctype=\"multipart\/form-data\" novalidate=\"\">\r\n<input type=\"hidden\" name=\"_jfb_current_render_states[]\" value=\"DEFAULT.STATE\" data-jfb-sync \/><input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_booking_form_id\" data-field-name=\"_jet_engine_booking_form_id\" value=\"137\">\r\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_refer\" data-field-name=\"_jet_engine_refer\" value=\"https:\/\/welltopia.care\/?rest_route=%2Fwp%2Fv2%2Fpages%2F23\">\r\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"__queried_post_id\" data-field-name=\"__queried_post_id\" value=\"23\">\r\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-3\">\n<div class=\"wp-block-column is-layout-flow\" style=\"flex-basis:66.66%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Patient Name<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\r\n\t<input name=\"text_field\" id=\"text_field\" type=\"text\" data-field-name=\"text_field\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"\">\r\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow\" style=\"flex-basis:33.33%\"><div  class=\"jet-form-builder-row field-type-select-field wp-block-jet-forms-select-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Cycle<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\r\n\t<select class=\"jet-form-builder__field select-field\" name=\"cycle\" data-field-name=\"cycle\" id=\"cycle\" data-jfb-sync=\"\">\r\n\t\t<option value=\"10\" >15th Cycle<\/option><option value=\"9\" >1st cycle<\/option><option value=\"8\" >All In One<\/option>\t<\/select>\r\n<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-6\">\n<div class=\"wp-block-column is-layout-flow\" style=\"flex-basis:66.66%\"><div  class=\"jet-form-builder-row field-type-textarea-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Note<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\r\n\t<textarea class=\"jet-form-builder__field textarea-field\" name=\"note\" data-field-name=\"note\" id=\"note\" data-jfb-sync=\"\"><\/textarea>\r\n<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow\" style=\"flex-basis:33.33%\"><div  class=\"jet-form-builder-row field-type-date-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Birth Date<\/div><\/div><input class=\"jet-form-builder__field date-field\" name=\"birth_date\" type=\"date\" data-field-name=\"birth_date\" id=\"birth_date\" data-jfb-sync=\"\"><div class=\"jet-form-builder__desc\"><small>Patient Birth Date<\/small><\/div>\n<\/div><\/div>\n<\/div>\n\n\n<div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"submit\" class=\"jet-form-builder__action-button-wrapper jet-form-builder__submit-wrap\">\r\n\t<button class=\"jet-form-builder__action-button jet-form-builder__submit submit-type-reload\" type=\"submit\">Submit<\/button>\r\n\t<\/div>\r\n\t\n<\/div>\t<div class=\"jet-form-builder-messages-wrap\" data-form-id=\"137\"><\/div>\r\n<\/form>\r\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Patient Name Cycle 1st cycle15th cycleAll In One Note Next Refill Medication Medication 7 AM 8 AM Noon 4 Pm 8 PM Note &times; Add new Submit<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"_links":{"self":[{"href":"https:\/\/welltopia.care\/index.php?rest_route=\/wp\/v2\/pages\/23"}],"collection":[{"href":"https:\/\/welltopia.care\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/welltopia.care\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/welltopia.care\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/welltopia.care\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23"}],"version-history":[{"count":7,"href":"https:\/\/welltopia.care\/index.php?rest_route=\/wp\/v2\/pages\/23\/revisions"}],"predecessor-version":[{"id":165,"href":"https:\/\/welltopia.care\/index.php?rest_route=\/wp\/v2\/pages\/23\/revisions\/165"}],"wp:attachment":[{"href":"https:\/\/welltopia.care\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}